重视2019冠状病毒病（COVID-19）诱导的脓毒症免疫抑制

周红; 李小丽; 李斌

doi:10.16016/j.1000-5404.202002172

您当前的位置：

首页 >

文章列表页 >

重视2019冠状病毒病（COVID-19）诱导的脓毒症免疫抑制

特别报道：新型冠状病毒病的防控 | 更新时间：2026-01-09

- 重视2019冠状病毒病（COVID-19）诱导的脓毒症免疫抑制
- Pay attention to 2019 coronavirus disease (COVID-19) induced sepsis immuno-suppression
- 第三军医大学学报 2020年42卷第6期页码：539-544
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金面上项目(81872914);国家自然科学基金面上项目(81673495);国家重大新药创制项目(2017ZX09101002-002-009)
- DOI：10.16016/j.1000-5404.202002172
  中图分类号：
- 收稿：2020-02-24，
  
  纸质出版：2020
- 稿件说明：
移动端阅览
周红, 李小丽, 李斌. 重视2019冠状病毒病（COVID-19）诱导的脓毒症免疫抑制[J]. 第三军医大学学报, 2020,42(6):539-544.

Hong Zhou, Xiaoli LI, Bin LI. Pay attention to 2019 coronavirus disease (COVID-19) induced sepsis immuno-suppression[J]. Journal of Third Military Medical University, 2020, 42(6): 539-544.
周红, 李小丽, 李斌. 重视2019冠状病毒病（COVID-19）诱导的脓毒症免疫抑制[J]. 第三军医大学学报, 2020,42(6):539-544. DOI： 10.16016/j.1000-5404.202002172.

Hong Zhou, Xiaoli LI, Bin LI. Pay attention to 2019 coronavirus disease (COVID-19) induced sepsis immuno-suppression[J]. Journal of Third Military Medical University, 2020, 42(6): 539-544. DOI： 10.16016/j.1000-5404.202002172.

摘要

Abstract

2019 coronavirus disease (COVID-19) is an infectious disease caused by SARS-COV-2 virus

and lacks specifically effective treatment till now. Its clinical manifestations and the concerning studies at home and abroad have shown that viral sepsis caused by SARS-COV-2 virus has typical characteristics of pathophysiology of sepsis

that is

early cytokine storm and subsequent immunosuppression stage. At present

although great attention has been paid to the treatment and clinical research on cytokine storm

the later stage of immunosuppression is neglected. Patients' lower immunity

secondary infection and multiple organ failure are quite common

and all these lead to rapid deterioration and even death. Therefore

it is of great significance to pay attention to the investigation and treatment of sepsis immunosuppression stage caused by COVID-19

and to study the drugs with bidirectional immune regulation such as artesunate so as order to reduce the mortality of patients with severe or critical COVID-19. What's more

we strongly recommend that chloroquine phosphate should be used with great caution for severe and critical patients.

关键词

Keywords

references

SINGER M DEUTSCHMAN C S SEYMOUR C W The third international consensus definitions for sepsis and septic shock (sepsis-3) JAMA 2016 315 8 801 810 10.1001/jama.2016.0287 SINGER M, DEUTSCHMAN C S, SEYMOUR C W, et al . The third international consensus definitions for sepsis and septic shock (sepsis-3)[J ] . JAMA, 2016, 315(8): 801-810. DOI: 10.1001/jama.2016.0287.

WENZEL R P EDMOND M B Septic shock: evaluating another failed treatment N Engl J Med 2012 366 22 2122 2124 10.1056/NEJMe1203412 WENZEL R P, EDMOND M B. Septic shock: evaluating another failed treatment[J]. N Engl J Med, 2012, 366(22): 2122-2124. DOI: 10.1056/NEJMe1203412.

FLEISCHMANN C SCHERAG A ADHIKARI N K Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations Am J Respir Crit Care Med 2016 193 3 259 272 10.1164/rccm.201504-0781OC FLEISCHMANN C, SCHERAG A, ADHIKARI N K, et al . Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations[J ] . Am J Respir Crit Care Med, 2016, 193(3): 259-272. DOI: 10.1164/rccm.201504-0781OC.

VAN DER POLL T OPAL S M Host-pathogen interactions in Sepsis Lancet Infect Dis 2008 8 1 32 43 10.1016/S1473-3099(07)70265-7 VAN DER POLL T, OPAL S M. Host-pathogen interactions in Sepsis[J]. Lancet Infect Dis, 2008, 8(1): 32-43. DOI: 10.1016/S1473-3099(07)70265-7.

QIU P LIU Y ZHANG J Review: the role and mechanisms of macrophage autophagy in sepsis Inflammation 2019 42 1 6 19 10.1007/s10753-018-0890-8 QIU P, LIU Y, ZHANG J. Review: the role and mechanisms of macrophage autophagy in sepsis[J]. Inflammation, 2019, 42(1): 6-19. DOI: 10.1007/s10753-018-0890-8.

WATANABE E THAMPY L K HOTCHKISS R S Immunoadjuvant therapy in sepsis: novel strategies for immunosuppressive sepsis coming down the pike Acute Med Surg 2018 5 4 309 315 10.1002/ams2.363 WATANABE E, THAMPY L K, HOTCHKISS R S. Immunoadjuvant therapy in sepsis: novel strategies for immunosuppressive sepsis coming down the pike[J]. Acute Med Surg, 2018, 5(4): 309-315. DOI: 10.1002/ams2.363.

HOTCHKISS R S MONNERET G PAYEN D Immuno suppression in sepsis: a novel understanding of the disorder and a new therapeutic approach Lancet Infect Dis 2013 13 3 260 268 10.1016/s1473-3099(13)70001-x HOTCHKISS R S, MONNERET G, PAYEN D. Immuno suppression in sepsis: a novel understanding of the disorder and a new therapeutic approach[J]. Lancet Infect Dis, 2013, 13(3): 260-268. DOI: 10.1016/s1473-3099(13)70001-x.

TORGERSEN C MOSER P LUCKNER G Macroscopic postmortem findings in 235 surgical intensive care patients with sepsis Anesth Analg 2009 108 6 1841 1847 10.1213/ane.0b013e318195e11d TORGERSEN C, MOSER P, LUCKNER G, et al . Macroscopic postmortem findings in 235 surgical intensive care patients with sepsis[J ] . Anesth Analg, 2009, 108(6): 1841-1847. DOI: 10.1213/ane.0b013e318195e11d.

周红刘鑫郑江脓毒症治疗:挑战与机遇并存第三军医大学学报 2013 35 2 91 94 10.16016/j.1000-5404.2013.02.027 周红, 刘鑫, 郑江.脓毒症治疗:挑战与机遇并存[J].第三军医大学学报, 2013, 35(2): 91-94. DOI: 10.16016/j.1000-5404.2013.02.027.

ZHOU H LIU X ZHENG J Sepsis treatment: Challenge and chance J Third Mil Med Univ 2013 35 2 91 94 10.16016/j.1000-5404.2013.02.027 ZHOU H, LIU X, ZHENG J. Sepsis treatment: Challenge and chance[J]. J Third Mil Med Univ, 2013, 35(2): 91-94. DOI: 10.16016/j.1000-5404.2013.02.027.

HUANG X VENET F WANG Y L PD-1 expression by macrophages plays a pathologic role in altering microbial clearance and the innate inflammatory response to Sepsis Proc Natl Acad Sci USA 2009 106 15 6303 6308 10.1073/pnas.0809422106 HUANG X, VENET F, WANG Y L, et al . PD-1 expression by macrophages plays a pathologic role in altering microbial clearance and the innate inflammatory response to Sepsis[J ] . Proc Natl Acad Sci USA, 2009, 106(15): 6303-6308. DOI: 10.1073/pnas.0809422106.

DELANO M J WARD P A Sepsis-induced immune dysfunction: can immune therapies reduce mortality? J Clin Invest 2016 126 1 23 31 10.1172/JCI82224 DELANO M J, WARD P A. Sepsis-induced immune dysfunction: can immune therapies reduce mortality?[J]. J Clin Invest, 2016, 126(1): 23-31. DOI: 10.1172/JCI82224.

XU Z SHI L WANG Y J Pathological findings of COVID-19 associated with acute respiratory distress syndrome Lancet Respir Med 2020 S2213 S2600(20)30076-X 10.1016/S2213-2600(20)30076-X XU Z, SHI L, WANG Y J, et al . Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J ] . Lancet Respir Med, 2020: S2213-S2600(20)30076-X.[Published online ahead of print ] . DOI: 10.1016/S2213-2600(20)30076-X.

LIU J LI SM LIU J Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients MedRxiv 2020.[2020-02-23] LIU J, LI SM, LIU J, <italic>et al</italic>. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients[J/OB]. MedRxiv, 2020.[2020-02-23]. https: //doi.org/10.1101/2020.02.16.20023671.

DIAO B WANG CH TAN YJ Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19) MedRxiv 2020.[2020-02-23] DIAO B, WANG CH, TAN YJ, <italic>et al</italic>. Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19)[J/OB]. MedRxiv 2020.[2020-02-23]. https: //doi.org/10.1101/2020.02.18.20024364.

ZUMLA A HUI D S MEMISH ZA Reducing mortality from 2019-nCoV: host-directed therapies should be an option Lancet. 2020 10.1016/S0140-6736(20)30305-6 ZUMLA A, HUI D S, MEMISH ZA, et al . Reducing mortality from 2019-nCoV: host-directed therapies should be an option[J ] . Lancet. 2020, S0140-6736(20)30305-6. HYPERLINK "https://doi.org/10.1016/S0140-6736(20)30305-6" DOI: 10.1016/S0140-6736(20)30305-6

GAO J J TIAN Z X YANG X Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies Biosci Trends 2020 10.5582/bst.2020.01047 GAO J J, TIAN Z X, YANG X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies[J]. Biosci Trends, 2020.[published online ahead of print]. DOI: 10.5582/bst.2020.01047.

ZHOU H ZHENG J WANG LX Chloroquine protects mice from challenge with CpG ODN and LPS by decreasing proinflammatory cytokine release Int Immuno-pharmacol 2004 4 2 223 234 10.1016/j.intimp.2003.12.006 ZHOU H, ZHENG J, WANG LX, et al . Chloroquine protects mice from challenge with CpG ODN and LPS by decreasing proinflammatory cytokine release[J ] . Int Immuno-pharmacol, 2004, 4(2): 223-234. DOI: 10.1016/j.intimp.2003.12.006.

MACFARLANE D E MANZEL L Antagonism of immunostimulatory CpG-oligodeoxynucleotides by quinacrine, chloroquine, and structurally related compounds J Immunol 1998 160 3 1122 1131 http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=799ea7fa0888b4f1273c6718466cf4c9 MACFARLANE D E, MANZEL L. Antagonism of immunostimulatory CpG-oligodeoxynucleotides by quinacrine, chloroquine, and structurally related compounds[J]. J Immunol, 1998, 160(3): 1122-1131.

REN C ZHANG H WU TT A potential therapeutic target for reversing sepsis-induced immunosuppression Front Immunol. 2017 8 1832 10.3389/fimmu.2017.01832 REN C, ZHANG H, WU TT, et al . A potential therapeutic target for reversing sepsis-induced immunosuppression[J ] . Front Immunol. 2017;8, 1832.DOI:10.3389/fimmu.2017.01832.

CAO T H JIN S G FEI D S Artesunate protects against sepsis-induced lung injury via heme oxygenase-1 modulation Inflammation 2016 39 2 651 662 10.1007/s10753-015-0290-2 CAO T H, JIN S G, FEI D S, et al . Artesunate protects against sepsis-induced lung injury via heme oxygenase-1 modulation[J ] . Inflammation, 2016, 39(2): 651-662. DOI: 10.1007/s10753-015-0290-2.

LI B ZHANG R LI J Antimalarial artesunate protects sepsis model mice against heat-killed Escherichia coli challenge by decreasing TLR4, TLR9 mRNA expressions and transcription factor NF-kappa B activation Int Immunopharmacol 2008 8 3 379 389 10.1016/j.intimp.2007.10.024 LI B, ZHANG R, LI J, et al . Antimalarial artesunate protects sepsis model mice against heat-killed Escherichia coli challenge by decreasing TLR4, TLR9 mRNA expressions and transcription factor NF-kappa B activation[J ] . Int Immunopharmacol, 2008, 8(3): 379-389. DOI: 10.1016/j.intimp.2007.10.024.

SHANG S L WU J LI X L Artesunate interacts with vitamin D receptor to reverse mouse model of sepsis-induced immunosuppression via enhancing autophagy bioRxiv 2020 10.1101/2020.02.26.966143 SHANG S L, WU J, LI X L, et al . Artesunate interacts with vitamin D receptor to reverse mouse model of sepsis-induced immunosuppression via enhancing autophagy[J ] . bioRxiv, 2020. DOI: 10.1101/2020.02.26.966143.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

123例COVID-19患者临床指标和免疫学特征的回顾性分析

线粒体预处理周细胞对脓毒症大鼠肺血管渗漏的保护作用

左旋肉碱对脓毒症心肌收缩功能障碍的改善作用及机制

PD-1介导的CD4⁺T细胞耗竭加剧脓毒症小鼠的肠道菌群异位

ATF3通过抑制ATG5和ATG16L1表达调控巨噬细胞自噬与炎症反应